Diarrhea is a major problem in a substantial percentage of patients receiving enteral feeding (see, for example, Guenter, P. A., et al., "Tube-feeding-related Diarrhea in Acutely Ill Patients," J. Parenter. Enter. Nutr., 15:277-280, 1991). Apart from patient discomfort, additional nursing care and hospitalization costs, such diarrhea can severely compromise patient health, because of depletion in fluid, electrolytes and other nutrients (see, for example, Frankenfield, D. C. and Beyer, P. L., "Soy-polysaccharide Fiber: Effect on Diarrhea in Tube-fed, Head-injured Patients," Am. J. Clin. Nutr., 50:533-538, 1989). Therefore, control of diarrhea has major clinical, psychosocial and financial benefits. Obviously, nutritional compositions which can help control diarrhea are highly desired.
The nutritional significance of dietary fiber has become apparent in the last two decades, and more recently, dietary fiber also has been included in enteral nutrition formulas. Dietary fiber has been suggested to be beneficial in diarrhea management because it may regulate GI transit time (Potkins, et al., "Effects of Structural and Non-structural Polysaccharides in the Diet of the Growing Pig on Gastric Emptying Rate and Rate of Passage of Digesta to the Terminal Ileum and Through the Total Gastrointestinal Tract," Br. J. Nutr., 65:391-413, 1991), adsorb excess luminal fluid, and/or be fermented to short chain fatty acids which stimulate colonic mucosal function and thus water and electrolyte absorption.
The effectiveness of commercially available enteral nutrition formulas with fiber (soy polysaccharide) is controversial (see, for example, Guenter, P. A., et al., "Tube-feeding-related Diarrhea in Acutely Ill patients," J. Parenter. Enter. Nutr., 15:277-280, 1991; Frankenfield, D. C. and Beyer, P. L., "Soy-polysaccharide Fiber: Effect on Diarrhea in Tube-fed, Head-injured Patients," Am. J. Clin. Nutr., 50:533-538, 1989; Shankardass, K., et al., "Bowel Function of Long-term Tube-fed Patients Consuming Formula With and Without Dietary Fiber," J. Parenter Enter Nutr., 14:508-512, 1990). A more successful approach may be the inclusion of highly fermentable soluble fiber, such as pectin or guar gum (Zimmaro, D. M. et al., "Isotonic Tube Feeding Formula Induces Liquid Stool in Normal Subjects: Reversal by Pectin," J. Parenter. Ent. Nutr., 13:117-123, 1989).
Pectin or guar gum as such are not suitable for use in liquid nutrition formulas as a source of dietary fiber, because they form very viscous aqueous solutions even at low concentrations. However, hydrolysis of pectin or guar gum dramatically decreases their viscosity (see, for example, vollmert, B., "Uber den alkalischen Pektinabbau," Makromol. Chemie, 5:110-127, 1950; Albersheim, P., et al., "Splitting of Pectin Chain Molecules in Neutral Solutions," Arch. Biochem. Biophys., 90:46-51, 1960; T. P. Krovtchenko, I. Arnold, A. G. J. Vorogen and W. Pilnik, "Improvement of the Selective Depolymerization of Pectic Substances by Chemical .beta.-elimination in Aqueous Solution," Carbohyd. Polym., 19:237-242, 1992). Little is known, however, about the use of such hydrolyzed fiber in nutritional products.
It would be highly desirable to have a nutritional product containing a soluble fiber which is of sufficiently low viscosity to be suitable for use in nutritional products and be useful for the management of diarrhea.